TY - JOUR T1 - Unrecognized sexually transmitted infections in rural South African women: a hidden epidemic. AU - Wilkinson,D, AU - Abdool Karim,S S, AU - Harrison,A, AU - Lurie,M, AU - Colvin,M, AU - Connolly,C, AU - Sturm,A W, PY - 1999/3/4/pubmed PY - 1999/3/4/medline PY - 1999/3/4/entrez KW - Africa KW - Africa South Of The Sahara KW - Delivery Of Health Care KW - Demographic Factors KW - Developing Countries KW - Diseases KW - English Speaking Africa KW - Estimation Technics KW - Health KW - Health Services KW - Infections KW - Measurement KW - Population KW - Population Characteristics KW - Prevalence KW - Reproductive Health--women KW - Reproductive Tract Infections KW - Research Methodology KW - Research Report KW - Rural Population--women KW - Sexually Transmitted Diseases--prevention and control KW - Sexually Transmitted Diseases--women KW - Signs And Symptoms--women KW - South Africa KW - Southern Africa KW - Treatment--women KW - Utilization Of Health Care--women KW - Women SP - 22 EP - 8 JF - Bulletin of the World Health Organization JO - Bull World Health Organ VL - 77 IS - 1 N2 - Sexually transmitted infections (STIs) are of major public health concern in developing countries, not least because they facilitate transmission of human immunodeficiency virus (HIV). The present article presents estimates of the prevalence, on any given day, of STIs among women in rural South Africa and the proportion who are asymptomatic, symptomatic but not seeking care, and symptomatic and seeking care. The following data sources from Hlabisa district were used: clinical surveillance for STI syndromes treated in health facilities, microbiological studies among women attending antenatal and family planning clinics, and a community survey. Population census provided denominator data. Adequacy of drug treatment was determined through quality of care surveys. Of 55,974 women aged 15-49 years, a total of 13,943 (24.9%) were infected on any given day with at least one of Trichomonas vaginalis, Neisseria gonorrhoeae, Chlamydia trachomatis, or Treponema pallidum. Of the women investigated, 6697 (48%) were asymptomatic, 6994 (50%) were symptomatic but not seeking care, 238 (1.7%) were symptomatic and would seek care, and 14 (0.3%) were seeking care on that day. Only 9 of the 14 women (65%) were adequately treated. STIs remained untreated because either women were asymptomatic or the symptoms were not recognized and acted upon. Improved case management alone is therefore unlikely to have a major public health impact. Improving partner treatment and women's awareness of symptoms is essential, while the potential of mass STI treatment needs to be explored. SN - 0042-9686 UR - https://www.unboundmedicine.com/medline/citation/10063657/Unrecognized_sexually_transmitted_infections_in_rural_South_African_women:_a_hidden_epidemic_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/10063657/ DB - PRIME DP - Unbound Medicine ER -